chapter  6
30 Pages

Integrated care

ByChristina Liossi

Introduction Despite an increasing awareness of the incidence and severity of paediatric acute pain, many children continue to su¡er pain and anxiety associated with medical procedures. Traditionally, intervention for medical procedures has focused on either psychological or pharmacological techniques. Few paediatric oncology departments provide their patients with both, and in the paediatric literature there is very little discussion of how to practically implement an integrated, pharmacological/psychological approach. The purpose of this chapter is to propose and discuss such an inte-

grated treatment approach that can be routinely implemented by healthcare providers when performing medical procedures (painful or not) in the paediatric oncology setting. The chapter begins with a discussion of the advantages and disadvantages of psychological and pharmacological techniques. A summary of the conceptual basis for a multidisciplinary approach and a speci¢c integrated treatment model for the management of pain associated with procedures are then presented. Particular emphasis is placed on the role of psychological factors in the model, and how they can be integrated with pharmacological treatment throughout the phases of a medical procedure. Finally, areas where further research is required are identi¢ed.